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Biomarkers for preterm birth
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markers were demonstrated to be calliver or not,” says Jacobsson. “There are granulin A and B and the human neusome tests around [for preterm birth] Preterm birth is responsible for 75% of trophil proteins 1, 2, and 3. These probut none of them are very good. We infant mortality and 50% of infant morteins have been previously detected in have great expectations that the inforbidity in the Western world. In this issue women diagnosed with preterm birth mation in [our] paper will help us along of JPR (pp 2236 –2242), Bo Jacobsson, and intra-amniotic inflammation. “Apart the route [to] a better test.” Ulla Rüetschi, and colleagues at the from doing the proteomics analysis [by Previous studies have examined preSahlgrenska University Hospital (SweSELDI TOFMS] and identifying the materm birth as a single clinical phenomeden) and the University of Aarhus (Denjor peaks, we also validated the identinon. However, Jacobsson, Rüetschi, and mark) have analyzed proteins in amnifications by western blotting,” says colleagues observed that the amniotic otic and cervical samples from patients Rüetschi. fluid profiles of women with inflammaas a step toward predicting which womAmniotic fluid samples are usually tion differed in cases of PTL and PPROM. en will deliver early. The researchers collected by amniocentesis, found biomarkers that indicate which is an invasive procedure. intra-amniotic inflammation Jacobsson, Rüetschi, and coland distinguish between two leagues tested cervical fluid types of preterm-birth events. samples for biomarkers to see Preterm birth has been prewhether amniocentesis can be viously linked to intra-amniotic avoided. The human neutrophil inflammation. The cases of preproteins calgranulin A and B term birth associated with inwere detected in cervical fluid, flammation tend to have a highbut there wasn’t a significant er proportion of complications difference in protein expression in the infant, such as cerebral levels between women with and palsy and bronchopulmonary without inflammation. dysplasia. The investigators Jacobson says the investigalooked for new and better intors are now expanding their flammation biomarkers in amstudy to >100 patients to see niotic fluid. They analyzed samwhether the observations hold ples from 27 women by using up on a larger scale. The reprotein fractionation on anionsearchers also say that a lot of exchange protein chip arrays work must be done to develop on the SELDI TOFMS platform. the experimental method. “ToRüetschi says that SELDI day, [the technique] is nowhere TOFMS “was very suitable for near the point where we can use this particular project because it as a diagnostic test. It’s not we didn’t have access to very really as robust technically as we large amounts of samples. For Preventing poor neonatal outcome. Biomarkers can distinwould like it to be [for] diagnoseach analysis, we used 20 µL of guish between two types of premature birth. tics,” explains Rüetschi. amniotic fluid. I would say it is But the investigators hope to almost impossible to do any ultimately achieve their goal of a other proteomic profiling with diagnostic test. Jacobsson explains that “One of the main achievements with this that little [amount of ] sample.” clinicians can initiate appropriate treatstudy is that we have been able to look Preterm birth can spontaneously ments for infants if they can determine at the difference [between PPROM and occur in two ways—preterm labor whether a woman will undergo preterm PTL]. It’s also interesting that there are (PTL) or preterm prelabor rupture of labor. He says, “The problem today is fewer [biomarkers] in the PPROM than in the membranes (PPROM). Women with you don’t have any good tests to [differthe PTL [groups],” says Jacobsson. The PTL have contractions, but their mementiate] between the women who will results suggested that PTL provoked a branes remain intact. PPROM patients actually deliver [early] or not.” With a greater intra-amniotic inflammatory rehave ruptured membranes but no conreliable test, the hope is that women sponse than PPROM. tractions. “The problem is, as a cliniwith a high risk of delivering early can Jacobsson, Rüetschi, and colleagues cian, I won’t be able to differentiate the be identified in time. identified 17 biomarkers that were inwomen entering the delivery ward —Rajendrani Mukhopadhyay creased in expression. Five of the bio[about whether] they are going to de-
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Journal of Proteome Research • Vol. 4, No. 6, 2005
© 2005 American Chemical Society
